Treating hypertension among inner-city dwellers: the problem of noncompliance.

Hypertension is perhaps the most common chronic disease in the United States, if not in the world. It is certainly the single most important chronic illness in which obtaining patient compliance to therapy is a challenging task. It is a lifelong, life-threatening condition, which may be completely asymptomatic in the afflicted individual. When this illness is detected early and given appropriate treatment, many of its complications, such as strokes, myocardial infarctions, renal disease, and retinal damage, can be prevented, or at least curtailed. The problem of noncompliance to therapy has been attacked in different ways by several investigators. The author believes that this problem can be approached using the following recommendations: thorough patient education, simplicity of therapy, elimination of drugs with serious side effects, and involvement of the patient and his family members in the therapeutic program. When these steps are taken, patient adherence to treatment usually improves, thus resulting in more effective management of hypertension and consequent reduction in its morbidity and mortality.